[The clinic anatomy of lumbar plexus in the lumbar anterolaterally approach minimally invasive surgery].
OBJECTIVE
To provide anatomic data for reducing lumbar plexus nerve injury.


METHODS
The applied anatomy of lumbar plexus was studied by 15 formaldehyde-preserved cadavers, two groups of sectional images of lumbar segment and three series of virtual chinese human dataset.


RESULTS
Arrangement of the lumbar nerve was regular. From anterior view, lumbar plexus nerve arranged from lateral to medial from L2 to L5; from lateral view, lumbar nerve arrange from ventral to dorsal from L2 to L5. The angle degree between the lumbar nerve and lumbar increased from L1 to L5. The lumbar plexus nerve was revealed to be in close contact with transverse process. By sectional anatomy, all parts of the lumbar plexus nerve were located in the dorsal third of the psoas major. The safety zone of the psoas major to prevent nerve injuries was ventrally 2/3.


CONCLUSIONS
Psoas major can be considered as surgery landmark when expose the lateral anterior of lumbar by incising the psoas muscle. Incising the psoas muscle ventral 2/3 can prevent lumbar plexus injury. Transverse process can be considered as landmark for the position of lumbar plexus in operation.
Lu
Sheng
S
Kunming General Hospital, Chengdu Military Region, People's Liberation Army, Kunming 650032, China. drlusheng@yahoo.com.cn
Xu
Yong-Qing
YQ
Ding
Zi-Hai
ZH
Shi
Ji-Hong
JH
Wang
Yue-Li
YL
Zhong
Shi-Zhen
SZ
D005260:Female; D006801:Humans; D008159:Lumbar Vertebrae / Q000033:anatomy & histology* / Q000601:surgery; D008160:Lumbosacral Plexus / Q000033:anatomy & histology*; D008161:Lumbosacral Region / Q000033:anatomy & histology; D008297:Male; D019060:Minimally Invasive Surgical Procedures